NEW PATIENT ORIENTATION QUIZ
First Name *
Last Name *
NEW PATIENT ORIENTATION
Chiropractics goal is to have you feel more or less? *
1 point
Stress can cause __________ to occur in the spine when there is a misalignment of the bones putting pressure on a nerve. *
1 point
Subluxations interfere with the messages sent back and forth between the ___________ and the body. *
1 point
Chiropractors correct Subluxations with an?
1 point
Clear selection
After an adjustment your innate healing ability immediately goes to work to help you_____________ *
1 point
Chiropractors find subluxations using ________. Check all that apply.   *
1 point
Required
If you’re not taking care of other areas of your health like eating healthy, _________________ foods, getting at least _______minutes of exercise a day, sleeping ______ hours a day and staying positive with daily prayer and/or __________________, it will take longer to heal. *
1 point
Required
The latest scientific research shows that getting your spine checked once every _______________ days not only helps you HEAL BETTER and FEEL MORE. But helps reduce the development of arthritis. *
1 point
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy